Healthcare Provider Details

I. General information

NPI: 1467557173
Provider Name (Legal Business Name): MAUREEN C PIERCE PHD INC PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22517 7TH AVE S
DES MOINES WA
98198-6820
US

IV. Provider business mailing address

22517 7TH AVE S
DES MOINES WA
98198-6820
US

V. Phone/Fax

Practice location:
  • Phone: 206-824-3950
  • Fax: 206-870-9081
Mailing address:
  • Phone: 206-824-3950
  • Fax: 206-870-9081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPY00002983
License Number StateWA

VIII. Authorized Official

Name: DR. MAUREEN CASANDRA PIERCE
Title or Position: PSYCHOLOGIST
Credential: PH.D.
Phone: 206-824-3950